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AC®a CERTIFICATE OF LIABILITY INSURANCE DATE[MMlil01Y YYI 10/15/2025 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Keegan Ferraro FAX SfafeFarm Keegan Ferraro PHONE Ext: 562-431-3933 lAfC No: •cm) 7923 Warner Ave Suite A EMAIL - keegan.ferraro.vaavhh@statefarm-eom INSLIRER(S)AFFORDING COVERAGE NAIC# Huntington Beach CA 92647 INSURERA: State Farm Mutual Automobile Insurance Company 25178 INSURED INSURER B: Anguiano,Juan INSURER C: PO BOX 2849 INSURER D: INSURER E: SEALBEACH CA 907401849 INSURERF: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NSR ADD SUB POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDDIYYYY MMIDDf= LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE s DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISFS(Ea occurrence S MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENT AGGREGATE LIMIT APPLIES PER; GENERAL AGGREGATE $ PRO- POLICY JECT F7 LOG PRODUCTS-COMPICP AGG $ OTHER, $ AUTOMOBILE LIABILITY COMRINFO SINGLE LIMIT 648 9314-FO6-75A 06/06/2025 12/06/2025 Fa accident s 1,000,000 ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED 4 AUTOS ONLY AUTos N N 648 2854-1706-75A 06/06/2025 12/06/2025 BODILY INJURY(Per accident) $ HIRED NON-OWNED AUTOS ONLY AUTOS ONLY Per accident $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE g DED I I RETENTION $ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY $ ANY PROPRIETOR/PARTNERIEXECUTIVE Y f N OFFICERIMEMBER EXCLUDED? NIA E.L.EACH ACCIDENT $ (Mandatory In NHI E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached If more space is requlredl City of Santa Ana, its City Council,officers,officials,employees,agents,and volunteers are named as additional insureds with respect to the general liability policy.Waiver of subrogation applies with respect to the general liability and workers'compensation policies, APPROVED BY Tu Tran NB�Y�r at iF:44 am,Oct 17,2025 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana Attm CIP Engineering ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza,M-36 AUTHORIZED REPRESENTATIVE Santa Ana CA 92701 This form was system-generated on 10/15/2025 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD 1001486 2005 155279 205 01-19-2023